II Complicated mental infantilism is a combination of mental infantilism with other psychopathological syndromes and symptoms

Mental infantilism is a condition in which an adult behaves like a child. He does not know how to control his emotions, think through actions several steps ahead, analyze and evaluate the situation. This disease can also develop in children. In both cases, it has serious consequences and greatly affects the quality of life. How to recognize it? Is it possible to get rid of infantilism and “grow up”?

general information

Mental infantilism is a pathology characterized by delayed emotional and personal development. The word "infantilism" comes from Latin. Means “infant, childish.” Essentially, this is a discrepancy between actions, emotions and feelings and age requirements. In ordinary life, an infantile person is naive, dependent on others, and often cannot cope even with common everyday problems.

Interestingly, mental infantilism syndrome is considered a separate disease in the International Classification of Diseases (ICD-10). Its name is infantile personality disorder.

In some cases, mental infantilism is a sign of neuroses and psychopathy. Sometimes this is a reaction to stressful situations. Of all patients, 1.6% are children. Moreover, there are equal numbers of boys and girls.

Be healthy!

Mental infantilism is a psychopathological condition based on a delay in the pace of emotional and personal development. It is manifested by childishness, immaturity of behavior, inability to make decisions, to make choices independently. Among schoolchildren, gaming interests predominate, learning motivation is weak, and it is difficult to accept rules of behavior and disciplinary requirements.

Diagnostics includes clinical and psychological methods and is aimed at studying the characteristics of the emotional-volitional and personal sphere, social relationships, and level of adaptation. Treatment is symptomatic and involves medication, psychotherapy and counseling.

General information

The term “infantilism” comes from the Latin language, meaning “infantile, childish.” Mental infantilism is understood as a discrepancy between behavior, emotional reactions, and volitional functions and age requirements. In everyday life, infantile people are people who are characterized by naivety, dependence, and insufficient knowledge of general everyday skills. The International Classification of Diseases (ICD-10) identifies a separate nosological unit - infantile personality disorder. In addition, mental infantilism is a symptom of neuroses, psychopathy, and reactions to stress. The prevalence among children reaches 1.6%, the ratio of boys and girls is approximately equal.

Causes

The prerequisites for mental infantilism are pathologies of the nervous and endocrine systems, hereditary predisposition, and improper upbringing. Risk factors include:

• Mild brain damage. Mental infantilism often develops after exposure to unfavorable prenatal, natal and postnatal factors. These include infections, intoxication, trauma, hypoxia, asphyxia.
• Mental disorders. Children with mental retardation, autism, schizophrenia, and mental retardation have a higher risk of developing mental infantilism. The syndrome is formed on the basis of social maladjustment.
• Hereditary burden. There are genetic and constitutional characteristics that are passed on to the child from the parents. The rate of maturation of cortical structures, metabolic processes, and inertia of the nervous system are factors influencing the formation of infantilism.
• Parenting style. The development of infantilism is facilitated by restriction of the child’s freedom and increased parental control. Mental immaturity is the result of overprotection or despotic upbringing.

Pathogenesis

There are three options for the pathogenesis of mental infantilism. The first is based on the delayed development of the frontal lobes of the brain, which are responsible for the formation of motives, goal-directed behavior, programming, regulation and control of mental activity. The causes are objective factors - trauma, intoxication, infection. The second variant of pathogenesis is general psychophysical immaturity. Developmental delay is detected in the frontal and other parts of the brain. Immaturity is total: the child is miniature, looks younger than his age, behavior matches his appearance. The third option is an artificial delay in socialization by a disharmonious parenting style. The development of frontal functions is inhibited by overprotection, excessive care, and total control.

Classification

Etiologically, the disorder is divided into congenital and acquired. A more detailed classification identifies 4 types of mental infantilism:

1. Organic. Occurs when the central nervous system is damaged. It is the result of traumatic brain injury, asphyxia, infectious disease, intoxication. Mental immaturity is accompanied by a mild psychoorganic syndrome.
2. Somatogenically caused. It is observed in endocrine diseases, chronic debilitating diseases, and damage to internal organs. Mental immaturity is formed against the background of symptoms of the underlying pathology, asthenic manifestations.
3. Psychogenically caused. Develops as a result of pampering upbringing, hyperprotection or despotic attitudes. Another name is psychological infantilism.

Another classification is based on the characteristics of the clinical picture. There are two types of mental infantilism:

• Total. The child is lagging behind in height, weight, physical and mental development. Appearance, behavior, emotions correspond to an earlier age.
• Partial. Mental immaturity is combined with normal, advanced physical development. The child is unbalanced, irritable, dependent on adults.

Symptoms

Mental immaturity is manifested by a lack of stability of attention, hasty unfounded judgments, an inability to analyze, build a plan, and control activities. Behavior is carefree, frivolous, self-centered. There is a pronounced tendency to fantasize. Understanding and accepting norms and rules is difficult; children often do not understand the concepts of “should” and “shouldn’t”, and do not maintain social distance when communicating with strangers, adults. The inability to assess the situation and change behavior according to external conditions reduces adaptive capabilities.

Children have difficulty adapting to an educational institution and duplicate classes. Often, a preschool child remains in a nursery group, while a primary school student remains in the preparatory group of a kindergarten. There is no mental retardation: patients begin to speak on time, ask questions, draw, sculpt from plasticine, and assemble construction sets in accordance with age standards.

Intellectual delay is formed secondarily, on the basis of maladjustment in society, and manifests itself during schooling. The emotional sphere is characterized by instability: the prevailing cheerfulness is sharply replaced by crying and anger when failures occur. Negative conditions pass quickly. There is no purposeful desire to cause harm or revenge. Emotions are unrestrained, superficial, pantomime is lively and expressive. True deep feelings are not formed.

The egocentric orientation of the individual is manifested by the desire to be in the center of attention, to receive praise and admiration from others. With disharmonious mental infantilism, children are perceived by their peers as equals, but communication does not work out. Gradually, isolation arises, exacerbating the hysterical traits of the infantile. Children with total infantilism make friends a year or two younger. Peers show a desire to care and protect. Socialization is more successful than with partial infantilism.

Complications

The main complication of mental infantilism is social maladjustment. It occurs due to the inability to accept social norms, control behavior, and assess the situation. Neurotic and personality disorders are formed: depression, anxiety, hysteroid psychopathy. Lag in emotional development leads to secondary intellectual delay. Concrete-effective and visual-figurative thinking predominates, a tendency to imitative activities when performing intellectual tasks, insufficient focus of mental activity, and weakness of logical memory. Academic failure begins to show up in the middle grades.

Diagnostics

Diagnosis of mental infantilism is carried out in preschool and high school age. The reason for turning to doctors is the child’s difficulties in adapting to the conditions, regime, and workload of educational institutions. The examination includes:

• A conversation with a psychiatrist. The specialist conducts a survey: clarifies the symptoms, their duration, severity, features of adaptation to school, kindergarten. Notes the child’s behavioral and emotional reactions: adequacy, ability to maintain distance, maintain a productive conversation.
• Drawing tests. The following techniques are used: “Drawing of a person”, “House, tree, person”, “Non-existent animal”. Infantilism is manifested by the inability to retain instructions, humanization of the animal, simplification of elements (straight trunk, arms) and other signs. The results are informative when examining preschoolers and junior schoolchildren.
• Situation interpretation tests. The methods “RAT”, “SAT”, and Rosenzweig’s frustration test are used. It is typical to perceive situations as playful, humorous, and funny. It is difficult to explain the thoughts and feelings of people in the pictures. The methods are used to examine schoolchildren of various ages.
• Questionnaires. The use of the Leonhard-Smishek character accentuation questionnaire and the pathocharacterological diagnostic questionnaire are widespread. Based on the results, emotional instability and traits of hysteroid and hyperthymic types are determined. The tests are suitable for diagnosing mental infantilism in patients over 10-12 years of age.

The differential diagnosis of mental infantilism is carried out with oligophrenia, autism, and behavioral disorders. The difference from mental retardation is the ability for abstract logical thinking, the ability to use help, and transfer acquired knowledge to new situations. The distinction with autism is based on an assessment of social relationships: the child needs them, but has difficulty establishing them. Behavioral disorders have a wide variety of manifestations and progressive dynamics. Mental infantilism can be a prerequisite for psychopathy, a symptom of mental retardation, and autism.

Treatment

Treatment measures are determined by the causes and form of the disorder. With somatogenic and organic mental infantilism, efforts are aimed at eliminating the underlying disease, with psychogenic - at psychotherapeutic correction. An integrated approach includes:

• Pharmacotherapy. Severe behavioral and emotional disorders can be treated with antipsychotics, tranquilizers, and antidepressants. Learning difficulties and decreased cognitive functions are corrected with nootropics.
• Psychotherapy. The most common use of the cognitive-behavioral approach. The psychotherapist works comprehensively with emotions, attitudes and behavioral patterns. The child learns new adaptive ways of social functioning.
• Consulting parents. A psychologist and psychotherapist talks about the characteristics of the mental and social development of children, and the influence of upbringing on this process. Emphasizes the relationship between overprotection, excessive control and the formation of mental infantilism.

Prognosis and prevention

Total mental infantilism has the most favorable prognosis: with psychological and pedagogical support, the child gradually becomes independent, active, and shows interest in research and creativity. Symptoms of the disorder disappear by 10-11 years. The disharmonious form of the syndrome requires deeper and longer-term medical and psychological intervention and is associated with the risk of cognitive deficits and psychopathic personality development.

The basis of prevention is proper upbringing, parents’ orientation to the child’s current needs, his zone of proximal development. It is necessary to encourage the child to be independent, set an example of adequately experiencing failures, and focus on achieving goals.

Reasons for the development of mental infantilism

The main reasons for the development of this mental illness are disturbances in the functioning of the nervous system, hormonal imbalances, and improper upbringing. This also includes genetic predisposition. Let's take a closer look.

Brain damage is considered one of the factors provoking the development of mental infantilism. They are the result of infections, intoxication, various injuries, asphyxia, oxygen starvation (hypoxia). This disease is a common companion with cerebral palsy (cerebral palsy).

The next factor is mental disorders. These include: mental retardation, autism, schizophrenia, developmental delay. In children and adults with such diagnoses, the risk of developing infantilism is significantly higher than in healthy people.

What can we say about heredity? A child receives many characteristics, including infantility, from his parents. In many ways, it is genetics that determines the level of inertia of the nervous system, the speed of metabolic processes, etc.

The danger of infantilism

The main danger for a person suffering from infantility is, of course, social maladjustment. As a result of the fact that it is difficult for such people to adapt to the world and people around them, they often find themselves alone, and they may have a feeling of inferiority and uselessness. This can ultimately lead to various kinds of neuroses and depression, which in some cases end in suicide.

For a child who was indulged in everything in childhood and protected in every possible way from difficulties and troubles, the frustrating circumstance will be that in adulthood he will have to decide everything himself, and no one will fulfill his wishes on demand. And this again will lead to the fact that such a person will be rejected by society. As a result, the risk of developing neuroses and depressive states with all the ensuing consequences increases.

In professional activities, such people also, as a rule, do not achieve significant success. They do not know how to navigate emergency, extreme situations, and often shift the solution to problems that arise onto the shoulders of their colleagues. In this regard, infantile people rarely occupy good positions and are fired quite often. Losing a job for people with this type of disorder is also akin to a disaster. It is very difficult for them to navigate what happened, adequately assess the reason for the dismissal and start looking for a new job. They, as a rule, blame the employer for their dismissal and go into their feelings about the injustice of what happened. Many never start looking for work, plunge into depression, start playing computer games, trying in this way to escape the reality that oppresses them. The financial situation is deteriorating, which leads to the fact that such people try to find a person who can be their dependent.

For those around them, infantile people do not pose a danger as such. As a rule, the main difficulties arise as a result of their immaturity and impaired social adaptation. At their core, they are big children, and in their professional activities such workers are ineffective in many areas. Any difficult situation can unsettle them and deteriorate the quality of work, which is undesirable for the employer. On the other hand, violations of social adaptation will lead to the fact that it will be difficult for such a person to join the work team and build adequate relationships with colleagues. And this will lead to industrial conflicts, which in turn will be very undesirable for the employer.

As for family life, as a rule, infantile people are afraid to take responsibility and get married and have children. But if this does happen, then you cannot rely on such people in family life. They are unlikely to be able to be the head of the family, they are unlikely to be able to fully provide for themselves and their loved ones, or cope with the difficulties that arise. And besides, a child raised in a family where there is an infantile parent is also highly likely to become infantile. Or he will form a misconception about the role of the mother or father in family life. Girls who grew up in a family with an infantile mother are highly likely to copy her infantile behavior when building their family life. If the father was infantile, then there is a high probability that such girls will choose infantile men in the future, since such a pattern of behavior will be the only possible one for them. The same thing happens with boys.

In addition, if it so happens that both parents are immature individuals, then the personal development of their child will also suffer. In almost one hundred percent of cases, the child will be infantile at best. In the worst case, mental retardation may also be added to this, or deviant behavior will begin to appear.

Classification system

Mental infantilism can be congenital or acquired. There are also 3 subspecies:

1. Organic (complicated). This is a consequence of damage to the central nervous system. Pathologies occur with traumatic brain injuries, asphyxia, infections and intoxication. Along with infantilism, a psychoorganic syndrome develops. It is characterized by memory deterioration, decreased intelligence, impoverished speech, and the inability to remember new and systematize old knowledge.
2. Somatogenically caused. The result of disturbances in the functioning of the endocrine system, chronic diseases leading to general exhaustion, and diseases of the internal organs.
3. Psychogenically caused. It develops with excessive care from parents, their despotism, and too gentle upbringing. Otherwise called psychological infantilism.

Another parameter for the classification of mental infantilism is the clinical picture. Pathology can be total or partial. In the first case, the child is severely behind in all types of development (uncomplicated infantilism). Neither his appearance, nor his behavior, nor his emotional state correspond to his age. Children are tireless in games, but do not show any intellectual interests.

With partial infantilism, physical development is fine. The psyche remains immature. The child is characterized by instability, irritability, and dependence on adults.

Causes, pathogenesis

Causes:

1. Chronic diseases suffered in childhood:
   liver, cardiovascular and circulatory systems, gastrointestinal tract;
2. tuberculosis;
3. syphilis, etc.
4. Diseases and injuries of the brain.
5. Birth injury.
6. Functional or organic hypothalamic-pituitary insufficiency:
   total;
7. partial;
8. Excessive alcohol consumption, parental drug addiction.
9. Poor material conditions:
   malnutrition;
10. avitaminosis.
11. Heredity.

Causes of infantilism in adults aged 20-40:

1. Lesions of the hypothalamus or pituitary gland:
   tumor;
2. traumatic;
3. vascular;
4. infectious-toxic.
5. Improper functioning of the endocrine glands.

The pathogenesis is as follows:

• the central nervous system (CNS) develops slowly, the functional activity of one or more endocrine glands is insufficient;
• metabolic processes are disrupted;
• underdevelopment of the genital organs.

Symptoms

The main signs of mental infantilism are:

• unstable attention;
• tendency to make unfounded judgments;
• failure to analyze information;
• lack of ability to plan your actions;
• carelessness;
• frivolity;
• tendency to fantasize.

Children diagnosed with “mental infantilism” do not understand prohibitions, do not know how to communicate with adults, and do not understand the need to keep their distance. There are other signs of the disease.

Moodiness

Represents variability, inconstancy. In an adult or child, desires change at lightning speed. This is not about changing requirements and preferences as you grow older. It talks about inadequacy, spontaneity.

Often, capriciousness is considered willfulness or stubbornness. One of its manifestations is mental immaturity. As a clear example, imagine a person who yesterday was ready to give everything he has for the fulfillment of a wish. Today he doesn't care about him. Are there such people among your friends?

Ways to combat infantilism

The psychological state in question really prevents a person from living, making him unhappy.

How can you get away from immaturity:

• Treatment of any psychological problem begins with its recognition. First you need to understand that it exists. A person needs to be helped to realize it, trying not to hurt his self-esteem. It’s difficult to talk to infantas because they don’t take criticism well, but you have to try. Otherwise, later life itself will put them in an offensive position.
• It is advisable to pull the infantile personality out of a familiar, comfortable environment. If an adult lives with his parents, then the right thing to do would be to move to separate housing, even rented one. The need to provide minimal needs on one’s own will force a person to grow up. An extreme way is to change the city or even the country of residence, where there are no friends or relatives.
• A person himself can start with small steps - organizing his life at home, putting things in order in the workplace. It will be difficult to immediately tackle the transformation of all areas of life; you can start with one.
• It is very useful for an infant to engage in reflection and think about the reasons for his childish, immature reactions to events. “Why was I so offended and angry?” The ability to manage emotions and not follow momentary impulses is an important part on the path to recovery.
• It is advisable to find motivators and set goals - strategic and for the near future. Next, you should plan the steps to achieve them, which you should strictly follow. Self-organization and a positive attitude will help instill the skills of adults.

You shouldn’t expect to grow up overnight; you won’t be able to give up your childhood in one fell swoop. But it’s worth trying, because only those who have responsibilities can have rights.

Possible complications

The main complication is the inability to adapt to the social environment and interact with society. There are other dangerous conditions:

• depression;
• anxiety;
• psychopathy;
• secondary intellectual delay.

The patient does not know how to control himself and is not able to adequately assess the situation. He is constantly looking for an example to follow. If mental infantilism has developed in a child, he will have problems with academic performance.

Higher mental functions

Perception. The level of analysis and synthesis of what is perceived suffers.

Motor skills. Monotony, irregularity, slowness, poor plasticity. Synkinesis. Instability of muscle tone, awkwardness of voluntary movements, poor facial expressions, gestures, the presence of unnecessary actions, lethargy.

Speech. Usually more impaired than other HMFs, but weaker than intelligence. The function of generalization is poorly reflected in speech; the semantic side suffers. Reduction of active (rougher) and passive vocabulary. The grammatical structure of speech is broken. What they lack in understanding they make up for in execution. A.R. Luria wrote about the violation of the regulatory function of speech (the role of speech in self-regulation).

Thinking. Intelligence is usually the most affected.

1. Personal-motivational level (regulatory function is impaired)
2. Operational level (relatively preserved)
3. Dynamic aspect (inertia)

The formation of concepts is difficult, logical schemes are not built (inability to generalize).

Lack of development of practical intelligence.

Memory.

• Natural, mechanical memory m.b. better than normal (10 words)
• Interference is increased.
• Semantic organization and mediation reduce the effectiveness of memorization.
• Semantic memory is also impaired.

Attention.

• Insufficiency, volume reduction.
• Instability.
• Voluntary attention suffers more. Where there is no attention, there is no way. place for wanting (Geller).

Diagnostics

Mental infantilism is diagnosed at school age. The reason for a visit to the doctor is the student’s inability to cope with increased workloads, as well as adapt to new conditions. The specialist prescribes a number of diagnostic measures:

1. First of all, this is a patient interview. Conducted by a psychiatrist. The doctor clarifies the symptoms and determines their severity. Checks how well the child is adapted to his environment. He also pays attention to the adequacy of behavior, the ability to carry on a conversation, concentrate attention and maintain distance.
2. The next stage is conducting special tests. The little patient is asked to draw a picture. It can depict a house, a person, animals, a tree, etc. Infantilism is manifested in giving animals human properties and characteristics, simplifying details.
3. Next, the child or adult needs to undergo another type of test. Drawing apperceptive (RAT), children's apperceptive (SAT). Here you should carefully examine the picture and tell what is happening in it.
4. At the end, the doctor suggests using questionnaires (pathocharacterological diagnostic, character accentuations by Leonhard Shmishek). They show the presence of emotional instability. Suitable for diagnosing mental infantilism in children over 10 years of age and adults.

Types of dysontogenesis according to V.V. Lebedinsky - Underdevelopment (first manifestations before 3 years)

Oligophrenia:

• endogenous (chromosomal abnormalities, congenital metabolic disorders)
• exogenous

Children with this type of developmental disorder vary in degree of mental retardation :

• idiocy
• imbecility
• imbecility

Diffuse (total) damage to the immature brain leads to underdevelopment of various brain systems. At the same time, it is difficult to form hierarchical connections between mental functions (perception, memory, attention), which is directly related to the lack of the regulatory function of thinking .

This type of dysontogenesis is characterized by:

• Motivational-volitional deficit . Instability of motivation - inability to maintain the program (deficit of regulatory functions).
• Lack of voluntary attention.
• Difficulty in assimilating social experience, poor learning ability (L.S. Vygotsky).
• Insufficient cognitive activity, weakness of the orienting reaction, which is based on underdevelopment of the cortex (S.L. Rubinstein)
• Totality and hierarchy of violations

Features of treatment, prognosis

Therapy directly depends on the form of mental infantilism, the severity of symptoms, and general health. Somatogenic and organic types of pathology involve eliminating the main disease. If it is psychogenically conditioned, work with a psychotherapist is required.

Complex treatment is carried out in 2 stages:

1. Taking medications. We are talking about antipsychotics, tranquilizers, antidepressants. They help get rid of emotional and behavioral disorders. Nootropics are used to solve learning problems. The duration of the course of treatment and dosage are determined by the doctor. Self-medication is extremely dangerous. It may worsen the condition.
2. Psychotherapy. The psychotherapist works with the patient’s emotions, teaches him how to adapt to society and communicate with people around him.

The doctor also consults with the parents of the infantile child. During the conversation, he explains the features of development and upbringing. Helps eliminate overprotection and strong control.

In general, mental infantilism has a favorable prognosis. Correctly prescribed treatment will eliminate both the symptoms of the disease and the cause of its development. If it comes to a child, by the age of 10-11 his condition will improve noticeably.

What are the problems of infantilism

The main problem of “adult children” is that an infantile personality cannot be truly happy. A person may not know what he really likes, because other people make all decisions for him.

Dependence on other people's opinions and reluctance to make decisions on their own can keep an “adult child” for many years in an unhappy marriage, in an unloved job. Infantile personalities are those people who easily succumb to the influence of others and risk becoming a victim of a manipulator.

Additional Information. It is the “big kids” who become participants in dubious scams and financial pyramids.

This is primarily due to the fact that infantiles love easy money and do not want to earn it through their own hard work.

Childhood infantilism can be a variant of the norm, because during this period of time the child is formed as a personality, tries something new for himself and discovers sides of his character. Childishness is acceptable and even encouraged if the child takes part in social life, is responsible for his actions and is capable of learning.

It is clear that a child, being an unformed and immature personality, will not yet be able to assimilate absolutely all the moral aspects of adult life on a subconscious level, however, parents must explain what needs to be done and what not, otherwise such upbringing will bring nothing but disappointment as parents , and so does the child.

As a rule, infantilism develops gradually; in addition to academic failure, restlessness, emotional lability, and a tendency to hysterics appear. The social circle of infant children often includes younger children, which indicates slow development. However, this condition is reversible and can be successfully treated when the child talks with his parents and a psychologist as needed.

Idiocy

Idiocy represents the most severe degree of mental retardation. People with this diagnosis completely lack speech and thinking functions. They are unable to care for themselves and have poor motor skills. Emotions are connected only with conditioned reflexes (hunger, cold, pain).

Note 2

Unfortunately, such patients cannot be treated. Adults with a similar diagnosis, just like children, cannot care for themselves.

Most often, the structure of internal organs is disturbed in patients. There are cases when idiocy is combined with paralysis, epilepsy, disruption of the endocrine glands, and various physical defects.

Attention is extremely poorly developed, even using methods of attracting attention, it is extremely difficult to focus their mental activity.

Often people with this disease experience aggression or auto-aggression; they are capable of harming themselves or others.

The IQ of patients is usually 0-5; in adults, the psychological age is less than three years.